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Pediatric Care Plan - Nursing Diagnosis and Interventions for Coarctation of the Aorta (CoA)

Nursing Diagnosis and Interventions for Coarctation of the Aorta (CoA)

1. Decreased cardiac output r / t cardiac malformations.

Goal : Maintain adequate cardiac output

Interventions :
  1. Observation of the quality and strength of the heartbeat, peripheral pulse, skin color and warmth.
  2. Assess the degree of cyanosis (circumoral, mucous membranes, clubbing).
  3. Monitor signs of CHF (anxiety, tachycardia, tachypnea, tightness, fatigue, periorbital edema, oliguria, and hepatomegaly).
  4. Collaboration therapy in accordance with the order, using the toxicity hazard prevention techniques.
  5. Give treatment to reduce afterload.
  6. Give diuretic as indicated.


2. Impaired gas exchange r / t pulmonary congestion.

Goal : Reduce the increased pulmonary vascular resistance

Interventions :
  1. Monitor the quality and rhythm of breathing.
  2. Adjust the position of children with Fowler position.
  3. Avoid the child of an infected person.
  4. Provide adequate rest.
  5. Provide optimal nutrition.
  6. Give oxygen if indicated.


3. Activity intolerance r / t imbalance between oxygen consumption by the body and oxygen supply to the cells.

Goal : Maintaining an adequate level of activity

Interventions :
  1. Allow the child to rest frequently, and avoid disturbances during sleep.
  2. Suggest to do the game and light activity.
  3. Help children to choose activities appropriate to the age, condition and abilities of children.
  4. Avoid ambient temperature is too hot or too cold.
  5. Avoid things that cause fear / anxiety in children.


4. Imbalanced Nutrition: less than body requirements r / t fatigue at mealtime and increased caloric needs.

Goal : Maintaining weight gain and height appropriate

Interventions :
  1. Provide a well-balanced diet, high nutrients to achieve adequate growth.
  2. Monitor height and weight, is documented in the form of a chart to determine the tendency of growth of children.
  3. Measure weight every day with the same weight and the same time.
  4. Record intake and output correctly.
  5. Give food with small portions but often to avoid fatigue at meals.
  6. Children who receive diuretics are usually very thirsty, therefore the fluid is not restricted.


5. Risk for infection r / t decline in health status

Goal : Children will not show signs of infection

Interventions :
  1. Avoid contact with infected individuals.
  2. Give adequate rest.
  3. Provide optimal nutritional needs.


6. Psychosocial Assessment include: age of the child, child development tasks, coping used, the child's habits, family response to childhood diseases, family coping and family adjustment to stress.

Goal : Provide support to parents

Interventions :
  1. Teach family / parents to express feelings of having children with heart defects, discuss treatment plan, and has an important role in the success of the treatment.
  2. Exploration feelings of parents about the feelings of fear, guilt, grief, and feelings of inadequacy.
  3. Reduce the fear and anxiety of parents by providing clear information.
  4. Involve parents in child care while in hospital.
  5. Give a boost to the family to involve other family members in child care.


Expected Results :
  1. The child will show signs of improvement in cardiac output.
  2. The child will show signs of the absence of an increase in pulmonary vascular resistance.
  3. Children will grow in accordance with the growth curve weight and height.
  4. Children will retain food and beverage intake to maintain weight and sustain growth.
  5. Children will not show signs of infection.
  6. Parents will express his feelings as a result of having a child with a heart defect, discuss treatment plan, and have confidence that parents have an important role in the success of the treatment.


Discharge Planning
  1. Control the time determined.
  2. Describe the needs of children activities that can be done in accordance with the age and condition of the disease.
  3. Teach the skills needed in the home, namely:
    • Drug delivery techniques.
    • Techniques feeding.
    • Measures to address the case of things that are worrying signs of complications, who will be contacted if needed help.
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